Challenges in Malaysia’s Mental Health Industry

I am a Psychology graduate who has been working in a private Psychiatric clinic for four months now, and though my working period could not be described as an extensive one, it did expose me to a unique and heartbreaking side of society where people struggled (sometimes daily) for their mental well-being. I hope then to share my own perspective with you in this article, with the intention to help you understand the challenges lying ahead in the field of our mental health industry.

Challenge 1: Stigma against mental illness

There is a pervasive stigma and misunderstanding against mental illness in general and those who have it, for example, the general public may think that people with Depression cannot work, or that people with Schizophrenia are “insane”, etc. These misunderstandings has prevented many from seeking professional assistance, or worse, to stop existing treatment programs because of the stigma attached to it. And because seeking help or information may indicate that you or your kin is “abnormal”, many chose to silence themselves and chose to fight with the illness on their own. Such is the negative influence of stigma, that people would rather forgo a chance of wellness for a sense of dignity.

It’s important to understand that sometimes willpower, and the willingness to fight the disease in and of itself is not enough to ensure recovery. Sometimes external support from medications and counseling sessions is integral in our road to recovery and everyday functioning. And sometimes the most harmful aspects of stigma came in the form of denial, when family members, even though they are willing to seek for help and bring their loved ones to our clinic, denies the fact that their loved ones are mentally ill, and refuse medication or counselling services.

Challenge 2: The fear of side effects from medication

Psychopharmacotherapy, or in brief, therapy that involves psychiatric medication, is one of the most common ways in reducing patients’ symptoms of mental illnesses. Yet, the belief that the intake of medications can lead to SIDE EFFECTs have lead to patients sometimes stopping or reducing the dosage of medications on their own without professional advice or guidance from a psychiatrist, leaving themselves in the vicious cycle of relapsing into their illnesses again and again. Taking medicines might lead to one being more vulnerable to certain kinds of side effects, yet it’s important to know about our priorities, and addressing one’s mental health will always have to come first, as side effects can be countered by a myriad of other ways. E.g.: Some antidepressants might make your mouth dry and sometimes causes constipation, in that case, make sure to drink enough water and take enough fibers.

This is one of the biggest challenges to psychiatrists because some patients will always stop medications on their own and opt for various health supplements (sometimes from unknown and dangerous sources), which leads to the aforementioned vicious cycle, which I will detail below:

Mental illness -> Requires Medications Support -> Not willing to take medications because of side effect -> Relapse -> Mental Illness

Personal note: Psychiatric medicines work by helping our brain regain its chemical balance, eg: antidepressants work by increasing our serotonin levels in our brain so that the symptoms of depression can be reduced. It’s ironic that we can accept the fact to take vitamin C supplements when we have a lack of vitamin C in our body, yet we cannot accept the fact when we need more serotonin levels in our brain. You will realize how important medication can be when you cannot communicate normally with another [when they are hallucinating] or even calm a person down [especially when they are in a manic stage].

Challenge 3: Low Awareness about Mental Health

Stress is considered as the root cause of most of the mental illnesses. When the amount of stress overrides our relaxation techniques and stress-coping strategies, we are vulnerable to fall mentally ill, as our moods and cognitive abilities are affected, while early signs and symptoms of mental illness manifest themselves. We tend to neglect how stress affects us physically and mentally because stress is invisible, and very difficult to detect unless one is constantly aware of their mental state and highly observant of subtle signs of stress in one’s self or another.

It appears that people are more concerned about their physical health than mental health. One of the main reasons could be that the symptoms of physical illnesses are more visible and detectable. And when it comes to differences in treatment duration, common physical maladies such as a cold or a fever takes a considerably shorter time to recover from than mental illnesses. So through this simple disparity alone, people would be much more tolerant and open to accept physical treatments because it’s easier to estimate when you will be well and healthy again (days or sometimes even hours, while psychotherapeutic treatments may take months, or even years).

Stress-coping strategies or relaxation techniques are important skills, considering the fact that we are now living in an increasingly fast-paced society, creating unforeseen stress to our psyche through high workload, lack of sleep due to constant working, the stress from being stuck in a heavy traffic jam, etc. These stressors can increase the chances of developing a disruption in our mental well-being. And so it is important that mental illness be receiving the treatment and amount of attention that physical illness does, as it also requires professional multidisciplinary supports from various professionals.

Note: there are various physical symptoms that can be caused by mental illness, e.g. people with depression tend to have an ongoing gastric pain. And visiting a physician will be to no avail because this is a somatic symptom that has an origin in one’s depression, which is a mental illness, and only if we seek out the root cause and stop it from developing worse, will the physical symptoms disappear.

Challenge 4: Stress of Family and Mental Health Services

Spotlight has been always directed to the patients’ needs and the symptoms of their illness, and this increasing attention towards mental health does lead to the formulation and advancing of modern therapies. Yet, there is a lack of attention directed towards the stress and responsibilities on the part of the patients’ caretakers.

We will never fully understand the difficulties of dealing or living with the mentally ill until you are in that position. You need to have patience and a willingness to understand the unique world of the patients, the open heart to accept the fact that they might not be aware of their thoughts and their behavior, which may be inappropriate or hurtful to the people around them, because of their afflictions.

Substantial support on dealing with the stress that comes with care-giving needs to be equipped among caretakers, because of the challenges that comes with the job of taking care of people suffering from mental illnesses, which requires great amounts of understanding, respect, love and care on the part of caregivers towards the patients.

If you know of someone who is taking care of people with mental illnesses, try to be more understanding and considerate towards them if they are stressed with their own issues, give them a helping hand if you can.

There are lots of unforeseen challenges that needs to be tackled before the field of the mental health industry can fully blossom and gain the recognition and attention it deserved, and these need to be addressed and tackled not only by the professionals, but also by the general public. It’s definitely a long run.

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Hailing from Sandakan, Sabah (The Land Below the Wind), Gary Yap has developed a keen interest in psychology and mental health issues ever since he was 15 years old. After receiving a Bachelor’s Degree of Psychology in HELP University, he volunteered at the Psychiatric Department of Duchess of Kent Hospital and worked as a para-counsellor at a private psychiatric clinic. He later completed his Master’s in Clinical Psychology at Universiti Kebangsaan Malaysia.
During his training in becoming a clinical psychologist, Gary was professionally trained at the Health Psychology Clinic, Universiti Kebangsaan Malaysia; the Psychiatry Department, in Hospital Kajang; and the Psychiatry Department in Universiti Kebangsaan Malaysia Medical Centre.
Gary is currently a clinical psychologist associate at SOLS Health and also the director of MY Psychology (Malaysia’s Leading Online Psychology Educational Platform) where he and his team utilized the strength of social media to increase psychological literacy and awareness about mental health issues in the public community. With the motto of “Learn . Share . Apply”, he is striving to build a society where psychology is for everyone.